Primena savremenih hirurških procedura u terapiji gingivalnih recesija

Background Mucogingival deformities result from anatomical and morphological irregularities in the mucogingival region. Gingival recession is the most common mucogingival deformity, and it represents a displacement of gingival margin apically from cement enamel junction. It presents itself with both a loss of soft and of hard tissues. The treatement of gingival recession is surgical. A ideal goal of gingival recession treatment is complete restauration of lost periodontal tissues. Subepithelial connective tissue graft in combination with coronally advanced flap is most common therapeutic approach in treatment of maxillary recession. On the other hand, Free gingival graft is first choise in treatment of mandibular recessions. Material and methods 20 patients from Department of Periodontology, School of Dentistry, University of Belgrade, have been enrolled in the study. Inclusion criterion was the bilateral presence of Miller class I or II single or multiple maxillary or mandibular gingival recessions. Split mouth design was used in the study. Patients were divided in two groups, in first group were patients with recessions localized on maxillary teeth and in second group were patients with recessions localized on mandibular teeth. In experimental group- first group of patients, gingival recessions were treated with Subepithelial connective tissue graft in combinatiom with split thickness flap (Tunel technique). In control group, gingival recessions were treated with Subepithelial connective tissue graft placed under a coronally advanced flap (Allen 1994). In experimental group, second group of patients, gingival recessions were treated with Subepithelial connective tissue graft in combination with split thickness flap (Tunel technique). In control group, gingival recessions were treated with Free gingival graft. Clinical parameters such as gingival recession coverage (RC), keratinized tissue width (KG), clinical attachment level (CAL), gingival index (GI) and plaque index (PI) were recorded at baseline, and three and six months postoperatively...Uvod Mukogingivalne anomalije se ispoljavaju kao posledica anatomo-morfoloških nepravilnosti u mukogingivalnom kompleksu parodontalnih tkiva i predstavljaju odstupanje od normalne dimenzije i morfologije u meĊusobnom odnosu gingive i alveolarne mukoze, a takoĊe mogu biti povezane i sa deformitetima alveolarne kosti. S obzirom na veliku uĉestalost u humanoj populaciji, one predstavljaju znaĉajan socio-epidemiološki problem. Gingivalna recesija predstavlja najĉešću mukogingivalnu anomaliju i nastaje usled morfoloških nepravilnosti u mukogingivalnom kompleksu. Gingivalna recesija ima uticaj na nastanak i prognozu parodontopatije i ukoliko se ne leĉi moţe da dovede do gubitka zuba. Odlikuje se gubitkom mekih i ĉvrstih tkiva u mukogingivalnom regionu, što dovodi do povećane osetljivosti eksponiranog korena zuba na nadraţaje i nepovoljnog estetskog izgleda. Terapija gingivalne recesije je hirurška. Realan cilj terapije gingivalne recesije jeste kompletno, predvidivo i u znaĉajnom periodu vremena stabilno prekrivanje površine korena zuba. U hirurškom leĉenju gingivalne recesije gornjih zuba najĉešće korištena terapijska metoda je Transplantat vezivnog tkiva u kombinaciji sa koronarno pomerenim reţnjem i vertikalnim relaksacijama, dok se u terapiji gingivalne recesije donjih zuba najĉešće primenjuje Slobodni mukozni autotransplantat. Materijal i metod U studiju je ukljuĉeno 20 pacijenata Klinike za Parodontologiju i oralnu medicinu Stomatološkog fakulteta u Beogradu. Kriterijumi za ukljuĉivanje u studiju bili su bilateralno prisusutvo izolovanih ili multiplih gingivalnih recesija klase I ili II po Miller-u u gornjoj vilici. Primenjen je metod podeljenih usta (“splith mouth”).svi pacijenti su podeljeni u dve grupe, prvu grupu su saĉinjavali pacijenti sa gingivalnim recesijama na gornjim zubima dok su drugu grupu ĉinili pacijenti sa gingivalnim recesijama na donjim zubima..

Advanced surgical techniques in gingival recession treatment

Uvod Mukogingivalne anomalije se ispoljavaju kao posledica anatomo-morfoloških nepravilnosti u mukogingivalnom kompleksu parodontalnih tkiva i predstavljaju odstupanje od normalne dimenzije i morfologije u meĊusobnom odnosu gingive i alveolarne mukoze, a takoĊe mogu biti povezane i sa deformitetima alveolarne kosti. S obzirom na veliku uĉestalost u humanoj populaciji, one predstavljaju znaĉajan socio-epidemiološki problem. Gingivalna recesija predstavlja najĉešću mukogingivalnu anomaliju i nastaje usled morfoloških nepravilnosti u mukogingivalnom kompleksu. Gingivalna recesija ima uticaj na nastanak i prognozu parodontopatije i ukoliko se ne leĉi moţe da dovede do gubitka zuba. Odlikuje se gubitkom mekih i ĉvrstih tkiva u mukogingivalnom regionu, što dovodi do povećane osetljivosti eksponiranog korena zuba na nadraţaje i nepovoljnog estetskog izgleda. Terapija gingivalne recesije je hirurška. Realan cilj terapije gingivalne recesije jeste kompletno, predvidivo i u znaĉajnom periodu vremena stabilno prekrivanje površine korena zuba. U hirurškom leĉenju gingivalne recesije gornjih zuba najĉešće korištena terapijska metoda je Transplantat vezivnog tkiva u kombinaciji sa koronarno pomerenim reţnjem i vertikalnim relaksacijama, dok se u terapiji gingivalne recesije donjih zuba najĉešće primenjuje Slobodni mukozni autotransplantat. Materijal i metod U studiju je ukljuĉeno 20 pacijenata Klinike za Parodontologiju i oralnu medicinu Stomatološkog fakulteta u Beogradu. Kriterijumi za ukljuĉivanje u studiju bili su bilateralno prisusutvo izolovanih ili multiplih gingivalnih recesija klase I ili II po Miller-u u gornjoj vilici. Primenjen je metod podeljenih usta (“splith mouth”).svi pacijenti su podeljeni u dve grupe, prvu grupu su saĉinjavali pacijenti sa gingivalnim recesijama na gornjim zubima dok su drugu grupu ĉinili pacijenti sa gingivalnim recesijama na donjim zubima...Background Mucogingival deformities result from anatomical and morphological irregularities in the mucogingival region. Gingival recession is the most common mucogingival deformity, and it represents a displacement of gingival margin apically from cement enamel junction. It presents itself with both a loss of soft and of hard tissues. The treatement of gingival recession is surgical. A ideal goal of gingival recession treatment is complete restauration of lost periodontal tissues. Subepithelial connective tissue graft in combination with coronally advanced flap is most common therapeutic approach in treatment of maxillary recession. On the other hand, Free gingival graft is first choise in treatment of mandibular recessions. Material and methods 20 patients from Department of Periodontology, School of Dentistry, University of Belgrade, have been enrolled in the study. Inclusion criterion was the bilateral presence of Miller class I or II single or multiple maxillary or mandibular gingival recessions. Split mouth design was used in the study. Patients were divided in two groups, in first group were patients with recessions localized on maxillary teeth and in second group were patients with recessions localized on mandibular teeth. In experimental group- first group of patients, gingival recessions were treated with Subepithelial connective tissue graft in combinatiom with split thickness flap (Tunel technique). In control group, gingival recessions were treated with Subepithelial connective tissue graft placed under a coronally advanced flap (Allen 1994). In experimental group, second group of patients, gingival recessions were treated with Subepithelial connective tissue graft in combination with split thickness flap (Tunel technique). In control group, gingival recessions were treated with Free gingival graft. Clinical parameters such as gingival recession coverage (RC), keratinized tissue width (KG), clinical attachment level (CAL), gingival index (GI) and plaque index (PI) were recorded at baseline, and three and six months postoperatively..

Komparativna analiza primene dveju tehnika transplantata vezivnog tkiva u lečenju recesija gingive

Introduction Gingival recession is a displacement of gingival margin apically to cement-enamel junction. Objective The aim of this study was to compare the results achieved with two different surgical procedures used in gingival recession treatment. Methods Ten patients with bilateral buccal recession on maxillary canines or premolars were included in the study. Professional teeth cleaning was performed before surgery. Recession on the experimental side was treated with connective tissue graft in combination with coronally advanced, split thickness flap (tunnel technique). Control side recession was treated with connective tissue graft in combination with trapezoidal coronally advanced, full thickness flap. Coin toss was used for side decision. The following parameters were evaluated before surgery and 6 months post-op: Vertical Recession Dimension, Clinical Attachment Level, Apico-coronal width of the keratinized tissue, Healing index (Laundry), RES index, and Patient evaluation of esthetic results. Student's t-test was used for statistical analysis. Results Six months after surgery, mean root coverage was 91.5±14.1% and 90.1±14.6% on the experimental and on the control side, respectively. RES index, Healing index (Laundry) and Patient Subjective evaluation of esthetic results showed significantly better results (p≤0.05). Conclusion Both surgical procedures produce highly successful clinical results based on evaluated parameters, but this tunnel technique provides significantly better esthetic results.Uvod Gingivalna recesija, koja nastaje kao posledica morfoloških nepravilnosti u mukogingivalnom kompleksu, loše utiče na nastanak i prognozu parodontopatije i odlikuje se nezadovoljavajućom estetikom. Cilj rada Cilj ove studije bio je da se uporede rezultati dobijeni primenom dveju različitih hirurških tehnika u lečenju gingivalnih recesija. Metode rada U studiju je uključeno 10 pacijenata Klinike za parodontologiju i oralnu medicinu Stomatološkog fakulteta Univerziteta u Beogradu. Osnovni kriterijum za uključivanje u studiju bilo je postojanje obostranih gingivalnih recesija I ili II klase prema klasifikaciji Milera (Miller) na gornjim očnjacima ili premolarima. Izvođenje studije odobrio je Etički odbor Stomatološkog fakulteta. Ispitanici su podvrgnuti hirurškom lečenju, obostrano, primenom metoda podeljenih usta. Jedna strana tretirana je primenom transplantata vezivnog tkiva tunel- tehnikom (eksperimentalna tehnika), a druga konvencionalnom tehnikom (kontrolna tehnika). Posmatrani klinički parametri - vertikalna dimenzija gingivalne recesije, nivo pripojnog epitela i širina keratinizovane gingive - zabeleženi su pre operacije i šest meseci nakon hirurškog lečenja. Zarastanje u ranoj postoperacionoj fazi procenjivano je na osnovu vrednosti indeksa tkivnog zarastanja. Objektivna procena estetskog ishoda terapije vršena je pomoću indeksa prekrivenosti korena zuba. Rezultati Šest meseci nakon intervencije primenom eksperimentalne tehnike ostvarena je prekrivenost korena od 91,5±14,1%, dok je primenom kontrolne tehnike ostvarena pokrivenost korena od 90,1±14,6%. Parametri za objektivnu procenu postignutih estetskih rezultata i indeksa zarastanja rane pokazali su statistički značajno bolje rezultate ostvarene primenom eksperimentalne tehnike. Zaključak Obe procedure uspešne su u lečenju gingivalne recesije i daju predvidljive rezultate, ali se primenom tunel- tehnike mogu očekivati bolji estetski rezultati

Broadening the urban sustainable energy diapason through energy recovery from waste: A feasibility study for the capital of Serbia

Metropolitan areas are large consumers of energy and there is a growing need to broaden the urban sustainable energy diapason and increase the share of renewable and sustainable energy in overall energy consumption. This is especially important in countries such as Serbia that have limited domestic fossil fuel resources and rely on energy imports, from the environmental, financial and energy security points of view. In the Serbian capital of Belgrade electricity is produced in coal-fired power plants that have been shown to be vulnerable to flooding and the district heating system is reliant on imported natural gas. The objective of this work was to perform a feasibility study of a combined heat and power municipal solid waste mass burn incineration facility in Belgrade. The feasibility study included a financial and an economic analysis. The City of Belgrade has a developed district heating system and locating the incineration facility next to an existing heating plant would enable the utilization of the heat energy produced by incineration and substitution of a portion of the imported natural gas currently used for district heating. The contributions of energy derived from waste incineration to the total energy consumption in Belgrade were also evaluated. The feasibility study showed that municipal solid waste incineration would be financially and economically positive and viable

Primena savremenih hirurških procedura u terapiji gingivalnih recesija

Background Mucogingival deformities result from anatomical and morphological irregularities in the mucogingival region. Gingival recession is the most common mucogingival deformity, and it represents a displacement of gingival margin apically from cement enamel junction. It presents itself with both a loss of soft and of hard tissues. The treatement of gingival recession is surgical. A ideal goal of gingival recession treatment is complete restauration of lost periodontal tissues. Subepithelial connective tissue graft in combination with coronally advanced flap is most common therapeutic approach in treatment of maxillary recession. On the other hand, Free gingival graft is first choise in treatment of mandibular recessions. Material and methods 20 patients from Department of Periodontology, School of Dentistry, University of Belgrade, have been enrolled in the study. Inclusion criterion was the bilateral presence of Miller class I or II single or multiple maxillary or mandibular gingival recessions. Split mouth design was used in the study. Patients were divided in two groups, in first group were patients with recessions localized on maxillary teeth and in second group were patients with recessions localized on mandibular teeth. In experimental group- first group of patients, gingival recessions were treated with Subepithelial connective tissue graft in combinatiom with split thickness flap (Tunel technique). In control group, gingival recessions were treated with Subepithelial connective tissue graft placed under a coronally advanced flap (Allen 1994). In experimental group, second group of patients, gingival recessions were treated with Subepithelial connective tissue graft in combination with split thickness flap (Tunel technique). In control group, gingival recessions were treated with Free gingival graft. Clinical parameters such as gingival recession coverage (RC), keratinized tissue width (KG), clinical attachment level (CAL), gingival index (GI) and plaque index (PI) were recorded at baseline, and three and six months postoperatively...Uvod Mukogingivalne anomalije se ispoljavaju kao posledica anatomo-morfoloških nepravilnosti u mukogingivalnom kompleksu parodontalnih tkiva i predstavljaju odstupanje od normalne dimenzije i morfologije u meĊusobnom odnosu gingive i alveolarne mukoze, a takoĊe mogu biti povezane i sa deformitetima alveolarne kosti. S obzirom na veliku uĉestalost u humanoj populaciji, one predstavljaju znaĉajan socio-epidemiološki problem. Gingivalna recesija predstavlja najĉešću mukogingivalnu anomaliju i nastaje usled morfoloških nepravilnosti u mukogingivalnom kompleksu. Gingivalna recesija ima uticaj na nastanak i prognozu parodontopatije i ukoliko se ne leĉi moţe da dovede do gubitka zuba. Odlikuje se gubitkom mekih i ĉvrstih tkiva u mukogingivalnom regionu, što dovodi do povećane osetljivosti eksponiranog korena zuba na nadraţaje i nepovoljnog estetskog izgleda. Terapija gingivalne recesije je hirurška. Realan cilj terapije gingivalne recesije jeste kompletno, predvidivo i u znaĉajnom periodu vremena stabilno prekrivanje površine korena zuba. U hirurškom leĉenju gingivalne recesije gornjih zuba najĉešće korištena terapijska metoda je Transplantat vezivnog tkiva u kombinaciji sa koronarno pomerenim reţnjem i vertikalnim relaksacijama, dok se u terapiji gingivalne recesije donjih zuba najĉešće primenjuje Slobodni mukozni autotransplantat. Materijal i metod U studiju je ukljuĉeno 20 pacijenata Klinike za Parodontologiju i oralnu medicinu Stomatološkog fakulteta u Beogradu. Kriterijumi za ukljuĉivanje u studiju bili su bilateralno prisusutvo izolovanih ili multiplih gingivalnih recesija klase I ili II po Miller-u u gornjoj vilici. Primenjen je metod podeljenih usta (“splith mouth”).svi pacijenti su podeljeni u dve grupe, prvu grupu su saĉinjavali pacijenti sa gingivalnim recesijama na gornjim zubima dok su drugu grupu ĉinili pacijenti sa gingivalnim recesijama na donjim zubima..